Medicaid Enrollment Up as Few People Drop Off

Friday, October 22, 2010

A new report on Medicaid in Ohio shows that total enrollment in the program has increased dramatically during the recession – not because more people are signing up, but because more people are staying on Medicaid and not dropping out.

The report, which will be released to an expert panel Oct. 25 in Columbus and also through a national webinar on Nov. 3 (registration information below), shows that 16 percent of enrollees dropped out of coverage in 2009, an improvement from 2007 when the percentage of children who dropped was 23 percent..

“Over the past three years, total enrollment in Ohio Medicaid programs has increased dramatically, from approximately 905,000 in 1997 to more than 1 million in 2009,” says Gerry Fairbrother, PhD, associate director of the Child Policy Research Center at Cincinnati Children’s Hospital Medical Center. “This increase in enrollment is due to more children being retained in the program. In 2009, 85 of 88 counties had reduced their drop rates to less than 20 percent.”

Although the report addresses results for Ohio, the results and methods used for monitoring enrollment can easily be translated to other states. In fact, national data show that large increases in enrollment are also projected for other states. These results and projections raise concerns about how the Medicaid system will deal with this increased enrollment in addition to overhauling the health system. States are reporting cutbacks in services.

A 2007 study of Dr. Fairbrother’s, published in Health Affairs, showed that major gaps in Medicaid coverage for children in many of the largest states in the nation, including Ohio, can affect both cost and quality of care. That study showed that fewer than half of children in Ohio in Medicaid or the State Children’s Health Insurance Program (SCHIP) are covered for three full years.

“Gaps in Medicaid coverage, known as ‘churning,’ can disrupt relationships with physicians, continuity of coverage and quality of care,” says Dr. Fairbrother. “This includes treatment regimens and medications.”

The reauthorization of CHIP in 2009 focused on increasing enrollment but also on enhancing retention through outreach and financial incentives. Dr. Fairbrother’s new report shows that African-American children are least likely to drop, while white, non-Hispanic children are most likely to drop. On a countywide basis, children living in Appalachian counties are least likely to drop from Medicaid.

Counties with the lowest drop rates tend to have higher percentages of new enrollees.

More information, and a complete copy of the report, can be found on the Cincinnati Children’s Web site at Search for "Child Policy Research Center".

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Cincinnati Children’s Hospital Medical Center is one of just eight children’s hospitals named to the Honor Roll in U.S. News and World Report’s 2010-11 Best Children’s Hospitals. It is ranked #1 for digestive disorders and highly ranked for its expertise in pulmonology, cancer, neonatology, heart and heart surgery, neurology and neurosurgery, diabetes and endocrinology, orthopedics, kidney disorders and urology. Cincinnati Children’s is one of the top two recipients of pediatric research grants from the National Institutes of Health. It is internationally recognized for quality and transformation work by Leapfrog, The Joint Commission, the Institute for Healthcare Improvement, the federal Agency for Healthcare Research and Quality, and by hospitals and health organizations it works with globally. Additional information can be found at

Contact Information

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